WEBVTT 1 00:00:47.780 --> 00:01:07.060 Porsche Dorsey: All right. So yeah, thanks. Everyone again for joining us today. Um, I know It's been a while. Um, of course, you know we've had some programmatic changes, so just trying to get a handle on everything. I'm as best we can, and you know as best we could serve you all as well as the umbos. So what I like to do, Melissa, is that we can go through 2 00:01:07.070 --> 00:01:26.379 Porsche Dorsey: um The I know we didn't have a a real set agenda for today. But if we could go through the items that's listed on confluence Um, I know that that has been a a point of some concern and questions, so I would like to um, at least provide a status update if we do not have um specific answers at this point. 3 00:01:27.070 --> 00:01:30.700 Melissa Fieldhouse: All right, I want to stop my share for a minute and get that page up. 4 00:02:00.700 --> 00:02:05.029 Melissa Fieldhouse: Okay, Can everybody see the screen now? It's just a list of questions. 5 00:02:07.490 --> 00:02:08.690 Porsche Dorsey: Yes. 6 00:02:09.320 --> 00:02:37.390 Porsche Dorsey: So first I want to say that everything that says the peritonitis questions are currently under discussion. Um, we do have a meeting schedule with the Cdc. Tomorrow morning. We just want to. Really. Um. We don't want to um keep going back and forth on these responses. So we want to nail down what will be uh what will be required once and for all, to really get that out there. So we really do appreciate your patience with this. I know that that has been taken a while. 7 00:02:37.400 --> 00:02:50.950 Porsche Dorsey: Um! But want you to know that we do recognize the importance of them, and we are working to get those answers up as soon as possible. So hopefully after tomorrow's discussion we'll be able to get those out shortly after 8 00:02:51.680 --> 00:02:53.750 Porsche Dorsey: any questions. There. 9 00:03:02.210 --> 00:03:03.500 Porsche Dorsey: Okay, 10 00:03:03.670 --> 00:03:07.089 Porsche Dorsey: What's that? See What's next? Melissa. 11 00:03:07.100 --> 00:03:12.810 Melissa Fieldhouse: I think the first one that wasn't a peritinitis question 12 00:03:13.410 --> 00:03:17.870 Melissa Fieldhouse: was Kathleen's question around the infections right here. Number eight, 13 00:03:19.250 --> 00:03:23.330 Porsche Dorsey: the four thousand. So that is also going to be discussed tomorrow, 14 00:03:23.340 --> 00:03:27.980 Porsche Dorsey: that the threshold of the four thousand 15 00:03:29.660 --> 00:03:33.730 Porsche Dorsey: for the fluid cell count. Is that what we're talking about? 16 00:03:36.070 --> 00:03:45.820 Kathleen Prewitt: It is. Yes, so that is paratenitis. So yes, yes. So yeah, yeah, Can we update that A response as well, Melissa. That's going to be discussed overall as well? 17 00:03:58.790 --> 00:04:00.430 Thank you. 18 00:04:06.690 --> 00:04:17.459 Porsche Dorsey: This is still um again peritonitis, so I know It's a it's a request for optional. But this is still great. Tonight is related, and we discuss tomorrow as well. 19 00:04:29.300 --> 00:04:39.850 Vlad Ladik: Um, yes, the language and the announcement um, for the module has since been updated and has gone out. The updated version has gone out. We remove language 20 00:04:39.860 --> 00:04:56.770 Porsche Dorsey: that speaks to the completion of the module being required. Um! So right now that that is left optional, it's and highly suggested Um, until we get these some of these features, some of these requirements finalize, and then we'll go from there 21 00:05:02.040 --> 00:05:09.130 Porsche Dorsey: Next we have what is that? Fourteen, twenty, seven, twenty, eight. So did we get this program expects? 22 00:05:09.770 --> 00:05:28.160 Porsche Dorsey: So it's twenty-two for a great rest of the time. In September release. Their production will follow after final updates are made based on the Pra recommendations. So I did see. There was some email going around about the Pra form that is now the two thousand seven hundred and twenty eight form that is now posted. So they um. 23 00:05:28.170 --> 00:05:38.690 Porsche Dorsey: The form that is posted is still in Pra. So that is not the final version of the form. However, that is the available version of the form 24 00:05:38.700 --> 00:05:45.049 Porsche Dorsey: the previous one has expired. So just let your folks know that 25 00:05:45.380 --> 00:05:59.089 Porsche Dorsey: that is Ah, I know It's like confusing. That is a form that could be used now, but it's not the final approved O. And B approved version of the form. 26 00:05:59.100 --> 00:06:11.280 Porsche Dorsey: We are technically still, I think, receiving comments for that form, I think, run our fine or round of comments, and we do have some updates to make regarding discussions with our own nation things of that nature so 27 00:06:11.290 --> 00:06:13.500 Porsche Dorsey: minor updates. Um, 28 00:06:13.700 --> 00:06:18.670 Porsche Dorsey: But you will see that coming with the final version of the form, 29 00:06:19.490 --> 00:06:21.429 Porsche Dorsey: any questions there, 30 00:06:25.300 --> 00:06:29.359 Nathan Muzos: he appreciates Nathan. So 31 00:06:29.630 --> 00:06:35.569 Nathan Muzos: guidance. If anyone asks should be continue to use what's available in eqrs 32 00:06:35.740 --> 00:06:38.070 Nathan Muzos: to complete a twenty-seven, twenty-eight 33 00:06:38.080 --> 00:06:39.220 Porsche Dorsey: correct, 34 00:06:41.560 --> 00:06:42.630 Nathan Muzos: he's 35 00:06:43.160 --> 00:06:48.409 Porsche Dorsey: Yeah, and we apologize for any confusion. But that is where we are right now. 36 00:06:48.710 --> 00:06:53.060 Nathan Muzos: Is there any way you guys could get Eoc to put out 37 00:06:53.190 --> 00:06:58.230 Nathan Muzos: an email to the broader community to reinforce that. 38 00:07:00.080 --> 00:07:01.640 Nathan Muzos: I think that would help 39 00:07:01.860 --> 00:07:03.730 Nathan Muzos: calm some confusion, 40 00:07:06.670 --> 00:07:15.550 Porsche Dorsey: so that, as what? What is the confusion stemming from? Or had folks taken it upon themselves to go to the Pra website because the um 41 00:07:15.560 --> 00:07:21.639 Porsche Dorsey: that form is not posted on the actual form. Cms. Forums website, 42 00:07:23.580 --> 00:07:26.779 Nathan Muzos: I think. Yes, people are finding it. 43 00:07:27.140 --> 00:07:32.510 Nathan Muzos: Uh, and they're saying, Oh, here's a new version. What do I do with this? 44 00:07:32.520 --> 00:07:36.550 Porsche Dorsey: So they're going to Pra instead of using what's in Eqrs? 45 00:07:40.460 --> 00:07:43.549 Nathan Muzos: They are finding the Pra form, 46 00:07:44.900 --> 00:07:53.079 Nathan Muzos: and so I think people are starting to ask questions around it. Which is, What does this mean? Are we supposed to be using this one. 47 00:07:53.540 --> 00:07:58.450 Nathan Muzos: It says it's from, you know, October of two thousand and twenty two, which is newer, 48 00:07:58.630 --> 00:08:01.090 Nathan Muzos: then the existing form, 49 00:08:01.220 --> 00:08:04.889 Nathan Muzos: and so I think it's just causing some confusion out there 50 00:08:05.910 --> 00:08:07.290 Nathan Muzos: around it. 51 00:08:08.700 --> 00:08:13.009 Nathan Muzos: Is this one, the new one. Should we be using the new one? 52 00:08:13.670 --> 00:08:24.339 Nathan Muzos: And so I mean, we obviously will put our guidance that we should just folks should continue to use the Eqs and to complete forms. And that's the current version. 53 00:08:24.390 --> 00:08:32.369 Nathan Muzos: I just think an email from eoct which has that backing of you guys uh would help calm 54 00:08:32.850 --> 00:08:34.450 Nathan Muzos: any confusion. 55 00:08:37.659 --> 00:08:42.669 Porsche Dorsey: Are um any of the other folks experiencing this as well in your facilities? 56 00:08:45.810 --> 00:08:56.519 Heather.Moore: This is how they're at us. Renewal care. We're definitely seeing an uptick facilities are going out and finding that we've even had a couple of network representatives 57 00:08:56.530 --> 00:09:06.990 to find them and contact us as well. So a communication would definitely be helpful to ease some of the concern out in the field. 58 00:09:09.940 --> 00:09:11.230 Vlad Ladik: Okay, 59 00:09:11.810 --> 00:09:16.849 Porsche Dorsey: Um, Do I have anyone on right now from I don't think I do, 60 00:09:17.780 --> 00:09:21.860 Matt McDonough: Melissa. This is a Matt. Mcdona from Eoct. 61 00:09:22.080 --> 00:09:31.150 Matt McDonough: Essentially a chat. But you know we're happy to send out communication, clarifying that on behalf of Cms. If directed to. 62 00:09:31.160 --> 00:09:45.650 Matt McDonough: Ah, we're also working on. We've been working with the team, knowing that that form is coming and preparing, and copious amounts of communication related to it when it's released. But obviously it's not released yet, so we can send clarification if needed. 63 00:09:50.580 --> 00:09:53.780 Porsche Dorsey: Thanks, Matt, and we'll get you some language around that. 64 00:09:53.790 --> 00:09:55.200 Matt McDonough: Appreciate that. Thank you. 65 00:10:04.120 --> 00:10:13.229 Porsche Dorsey: And, Nathan. Did you send the link to the October version? I have the June version, and obviously the expired version. 66 00:10:14.050 --> 00:10:20.680 Porsche Dorsey: So it's funny that your your folks are finding it. I do not have the October version, is it? It's posted on cms 67 00:10:20.690 --> 00:10:21.629 Porsche Dorsey: that go. 68 00:10:23.870 --> 00:10:28.569 Nathan Muzos: It was on the Pra site 69 00:10:28.810 --> 00:10:30.540 Nathan Muzos: for me. 70 00:10:31.060 --> 00:10:36.970 Porsche Dorsey: Yeah. The pra site is dated um six to two thousand and twenty-three. That's the June second 71 00:10:37.860 --> 00:10:42.590 Michael Kennedy: it Porsche. It's Michael. I can probably help clear up where they got, so that 72 00:10:42.600 --> 00:10:53.189 Michael Kennedy: the updated one was posted on the Cms. Site for a little bit, and then take it back there on it and repost it, and then take it back there and again. So people may have had a chance to get it while it was there. 73 00:10:53.200 --> 00:10:54.190 Porsche Dorsey: Gotcha 74 00:10:54.200 --> 00:10:55.100 Michael Kennedy: no 75 00:10:55.110 --> 00:10:57.090 Gotcha. Okay, no. That makes sense. 76 00:10:57.100 --> 00:11:09.599 Jason Clem: Well, the information that's there now is a crosswalk of the new fields and the new form. It's just dated incorrectly. So it's kind of a jumble of two. 77 00:11:12.760 --> 00:11:16.240 Porsche Dorsey: Yeah, okay, Then we'll get some language out around that 78 00:11:16.540 --> 00:11:22.119 Porsche Dorsey: it's directing folks to the form of record, for now, until we get the update, it went out 79 00:11:25.180 --> 00:11:39.029 Nathan Muzos: awesome. Thank you. And yeah, the to clarify the October June thing, it's posted on the website as of June. But when you look at the Pdf. Of the two thousand and twenty-eight it's got 80 00:11:39.270 --> 00:11:42.579 Nathan Muzos: one thousand and twenty-two after the form number. 81 00:11:48.130 --> 00:11:55.270 Nathan Muzos: That's where they October. That's where people are seeing. Oh, this is where form is as of October. That means it's newer. 82 00:11:55.400 --> 00:11:57.089 And my, you know that kind of thing. 83 00:11:57.100 --> 00:11:57.890 Porsche Dorsey: Gotcha. 84 00:11:57.900 --> 00:12:00.190 Porsche Dorsey: No, I see it. I see what you're talking about. 85 00:12:00.290 --> 00:12:03.990 Porsche Dorsey: Okay, all right. We'll get that language out. Thank you. Nathan. 86 00:12:04.000 --> 00:12:05.659 Nathan Muzos: Yeah, thank you 87 00:12:07.180 --> 00:12:10.259 Porsche Dorsey: anything else on the twenty-seven, twenty-eight. 88 00:12:16.980 --> 00:12:19.860 Nathan Muzos: Yeah, I mean I I I know the 89 00:12:20.680 --> 00:12:25.059 Nathan Muzos: some of fifteen through seventeen. You know is the 90 00:12:25.430 --> 00:12:29.139 Nathan Muzos: covered under the that that's not the new version. 91 00:12:29.250 --> 00:12:33.290 Nathan Muzos: But I don't think it would hurt to start talking about the other things, 92 00:12:33.530 --> 00:12:36.719 Nathan Muzos: especially fifteen and seventeen. 93 00:12:37.080 --> 00:12:38.320 Nathan Muzos: Um, 94 00:12:39.140 --> 00:12:40.090 Nathan Muzos: you know, 95 00:12:40.980 --> 00:12:45.490 Nathan Muzos: as you guys have heard already without any kind of formal communication 96 00:12:45.680 --> 00:12:51.660 Nathan Muzos: about this happening. It's causing confusion. And so just interested in the 97 00:12:52.540 --> 00:12:58.470 Nathan Muzos: what kind of if you guys have and can share What kind of a communications plan 98 00:12:58.690 --> 00:13:12.670 Nathan Muzos: Ah, there is for this! Can we be brought in So we can reinforce that messaging and message the same things, I think what we've experienced for years is as much as the Eoc T. Messages are great, 99 00:13:12.850 --> 00:13:15.259 Nathan Muzos: and our messages internal, are great. 100 00:13:15.460 --> 00:13:20.340 Nathan Muzos: One by itself isn't doesn't seem to be enough. Unfortunately 101 00:13:20.350 --> 00:13:37.449 Nathan Muzos: it's where eoc t sends stuff. We send stuff networks and stuff that it finally gets. People's attention, um, and if we can ensure that all of those things are messaging aligned. I think it would just help throughout this process, because this, 102 00:13:37.910 --> 00:13:41.900 Nathan Muzos: just from what I'm hearing on the is this: The new form 103 00:13:42.080 --> 00:13:45.670 Nathan Muzos: has a lot of people concerned about this form changing 104 00:13:46.090 --> 00:13:47.220 Nathan Muzos: um, 105 00:13:47.650 --> 00:13:49.580 Nathan Muzos: And so any sort of 106 00:13:49.650 --> 00:13:50.880 Nathan Muzos: pre 107 00:13:51.630 --> 00:13:53.280 Nathan Muzos: messaging? 108 00:13:53.900 --> 00:13:55.270 Nathan Muzos: Ah 109 00:13:55.520 --> 00:14:00.180 Nathan Muzos: concerted a plan. I think we'll just help with roll this out. 110 00:14:06.210 --> 00:14:13.509 Porsche Dorsey: I'm talking on mute. You're looking for messaging before the actual release of the Forum to start getting folks on board 111 00:14:13.740 --> 00:14:15.399 Porsche Dorsey: with the changes. 112 00:14:17.090 --> 00:14:19.560 Nathan Muzos: Yeah, I mean, I think if we 113 00:14:19.960 --> 00:14:27.480 Nathan Muzos: you know, we know it's coming sometime this year, I believe I think we are confident in that. You know It's already august, the 114 00:14:27.770 --> 00:14:36.159 Nathan Muzos: so any kind of messaging to say, Hey, this is coming. You will hear more in the future. We have a plan that 115 00:14:36.490 --> 00:14:38.299 Nathan Muzos: you know is going to help 116 00:14:38.960 --> 00:14:44.300 Nathan Muzos: let people know. Be prepared for it. Become aware of it. 117 00:14:44.770 --> 00:14:53.520 Nathan Muzos: That kind of thing versus a waking up on a Monday, and hearing there's a new version of the two thousand and twenty-eight you have to start using today. 118 00:14:54.380 --> 00:15:18.730 Porsche Dorsey: The only thing i'll say to that is, I agree. Um, you would always. I mean that's just good. Pr um With anything that that is being released I will say that we have to be careful. Um, because changes haven't been finalized. We can't speak too much in the form at this time. We can't speak to many of the changes at this time. Um before prior to them being approved. 119 00:15:18.840 --> 00:15:34.050 Porsche Dorsey: Um, so it it would be again. Ah, as Matt stated earlier, he has a lot of communication coming on this. Um, but they are even not allowed to launch a lot of it until the form is finalized. So what 120 00:15:34.060 --> 00:15:43.750 Porsche Dorsey: I I agree with the approach. The content, however, would be lacking, and it may lead more questions than answers. 121 00:15:52.970 --> 00:15:57.840 Leah Skrien: This is Leah from Network sixteen, and I 122 00:15:58.020 --> 00:16:09.229 Leah Skrien: appreciate that you would be considering that, and that eoc t is putting a lot of consideration into the training I mean this. This is one of the most significant changes to the form and 123 00:16:09.270 --> 00:16:18.100 Leah Skrien: decades. So any anything. It's going to take a very long time 124 00:16:18.130 --> 00:16:28.980 Leah Skrien: from the launch of the training, I think, for facilities to understand what's being asked on the form, and that doesn't even take into account the Edi submission portion of it. So 125 00:16:28.990 --> 00:16:43.719 Leah Skrien: yeah, I I appreciate any any training or guidance that can be released either to facilities or even to the edis and networks ahead of time. It could also be helpful. So we're prepared. 126 00:16:48.110 --> 00:16:52.090 Porsche Dorsey: So how about this? What would you all like to see? 127 00:16:52.270 --> 00:17:02.629 Porsche Dorsey: And a perfect world which we know the world isn't perfect? So let me preface that question. But what would you all like to see and like to receive ahead of its actual release. 128 00:17:07.680 --> 00:17:15.460 Nathan Muzos: I'll jump in just because i'm not shy to jump in. I would love to see a plan to start with. Just a 129 00:17:15.589 --> 00:17:27.630 Nathan Muzos: It can be broad, high, level. Ah, I we get that. Things are not final. You know that you're. We have to wait on omb or pra, or whatever the entity is that has to approve it. 130 00:17:27.760 --> 00:17:32.470 Nathan Muzos: Um! But you know, I think it would be great to see some kind of a 131 00:17:33.240 --> 00:17:34.840 Nathan Muzos: A. T minus, 132 00:17:35.260 --> 00:17:40.980 Nathan Muzos: you know, from the approval date, you know. So the T. Minus four weeks 133 00:17:41.360 --> 00:17:45.830 Nathan Muzos: uh just general announcements that a new version is coming, 134 00:17:46.310 --> 00:17:49.489 Nathan Muzos: you know it's not approved, so we can't share details, 135 00:17:49.600 --> 00:17:53.790 Nathan Muzos: but it's coming, you know. Every 136 00:17:54.070 --> 00:17:55.890 Nathan Muzos: ect 137 00:17:56.050 --> 00:18:03.589 Nathan Muzos: message and training from that date on has some little blurb that says reminder New twenty, seven hundred and twenty eight coming later this year, 138 00:18:03.960 --> 00:18:07.020 Nathan Muzos: you know, having, 139 00:18:09.000 --> 00:18:11.489 Nathan Muzos: and then um, 140 00:18:11.670 --> 00:18:14.150 Nathan Muzos: you know, when it's approved. 141 00:18:14.600 --> 00:18:17.349 Nathan Muzos: I think it's also having a plan. 142 00:18:17.570 --> 00:18:18.820 Nathan Muzos: Sure, 143 00:18:18.960 --> 00:18:25.730 Nathan Muzos: the system, you know. So one of the other questions in here is what happens between when it's approved 144 00:18:25.920 --> 00:18:34.609 Nathan Muzos: when Eqrs is updated. My assumption is, those won't be the same day, and that there will probably weeks or months in between 145 00:18:34.940 --> 00:18:37.479 Nathan Muzos: um. And so how do we handle that 146 00:18:37.980 --> 00:18:40.669 Nathan Muzos: you don't have those things 147 00:18:43.460 --> 00:18:50.529 Nathan Muzos: already outlined. Have it built into the trainings so that we know what questions Pip, and we're probably going to ask the 148 00:18:50.720 --> 00:18:56.440 Nathan Muzos: you know some questions. What happens if I have a form and safe status 149 00:18:57.570 --> 00:19:01.490 Nathan Muzos: today in the old version? Can I finish it? 150 00:19:01.590 --> 00:19:05.520 Nathan Muzos: Is it going to get deleted out of eqos, and I got to start new. 151 00:19:05.600 --> 00:19:10.740 Nathan Muzos: You know some of these types of process questions throughout the transition 152 00:19:11.570 --> 00:19:12.860 Nathan Muzos: Um, 153 00:19:13.270 --> 00:19:24.819 Nathan Muzos: and then we could get into the whole system side of the Edi stuff. The The plan for updating Eqs technical documentation, all of that you know. I think that's less field-facing, 154 00:19:24.920 --> 00:19:29.620 Nathan Muzos: less impactful from that perspective, but not less impactful 155 00:19:29.760 --> 00:19:32.420 Nathan Muzos: for Kathleen and I 156 00:19:32.620 --> 00:19:34.440 Nathan Muzos: and our organizations 157 00:19:34.790 --> 00:19:38.559 Nathan Muzos: I only say our organizations because they 158 00:19:39.010 --> 00:19:45.809 Nathan Muzos: send the forms today and and we have shared. We are actively working on building our logic to send these forms, 159 00:19:51.840 --> 00:19:54.150 but would love to hear from others as well. 160 00:20:01.330 --> 00:20:08.820 Michael Kennedy: I don't see Howard on Nathan, but Nra also that some of their clients also submit via ads. For two thousand and seventeen. 161 00:20:20.150 --> 00:20:26.180 Porsche Dorsey: You have no facilities or representatives at least agree with what Nathan before. 162 00:20:30.740 --> 00:20:40.110 Kathleen Prewitt: But yes, So this company with Percent is. I do agree with what makes them instead, and you know I 163 00:20:40.380 --> 00:20:58.099 Kathleen Prewitt: I share the same concerns about field communication. But to this point that Presidius is already batching twenty-seven twenty-eight I also have a high concern about the transition to the new form and in qrs, just because 164 00:20:58.110 --> 00:21:14.600 Kathleen Prewitt: we implemented this ah logic to take a burden off of the clinics and help them with this high-profile task. You know that has far-reaching implications across the program for the patient, 165 00:21:14.610 --> 00:21:34.050 Kathleen Prewitt: and, you know, not having a plan in place that will keep us in step and able to turn around quickly and and report to a new form, puts the burden back on the clinic. And, what is, I think, we all agree, a very trying time. Ah, now, in our industry. 166 00:21:34.060 --> 00:21:51.690 Kathleen Prewitt: So you know, just we, we really want to to be in step with you as this is built because it's not just the twenty, one twenty-eight in it, I mean, if you move to where is it? Question Seventeen from? Maybe 167 00:21:51.700 --> 00:22:06.299 Kathleen Prewitt: it's also going to impact the patient demographics, which not even twenty, seven, twenty, eight related. That's been, in fact, how we can even imagine admissions for patients, um and and changes to their demographic information. So 168 00:22:23.620 --> 00:22:39.890 Nathan Muzos: the other thing I would recommend that we haven't always seen we we have seen Ah, it Occasionally we saw it. Ah, with vaccinations, and I'm trying to think we saw Howard room would remember better. But 169 00:22:40.290 --> 00:22:45.019 Nathan Muzos: a concerted testing plan of Eqs the 170 00:22:45.220 --> 00:22:46.460 Nathan Muzos: um, 171 00:22:47.160 --> 00:22:50.879 Nathan Muzos: you know, with peritonitis, the testing and the production 172 00:22:51.440 --> 00:22:55.059 Nathan Muzos: actually production went first, and then. Now we are able to test the 173 00:22:55.120 --> 00:22:57.560 Nathan Muzos: pre-prod, 174 00:22:57.850 --> 00:23:07.500 Nathan Muzos: even if it isn't a batch uploading that we're able to test before launch ideally it would be, but at least being able to manually 175 00:23:07.630 --> 00:23:15.500 Nathan Muzos: completing forms through this group in pre-prod. So that we know, if you check this box, 176 00:23:15.960 --> 00:23:21.729 Nathan Muzos: it also lets you check the other boxes when it's allows a multi selection where you can type in 177 00:23:22.240 --> 00:23:26.410 Nathan Muzos: social security number in that field, but not a first name, 178 00:23:26.500 --> 00:23:30.039 Nathan Muzos: you know, just the minor validation stuff you 179 00:23:30.840 --> 00:23:33.730 Nathan Muzos: doesn't always seem to happen, so that 180 00:23:33.820 --> 00:23:42.000 Nathan Muzos: at least, if the field is manually completing these, we know that the system behavior, and the interface is working as expected. 181 00:24:06.240 --> 00:24:08.609 Melissa Fieldhouse: Of course, if you're speaking, you're on youth. 182 00:24:10.480 --> 00:24:19.690 Porsche Dorsey: Thank you very much. I was actually speaking in my head first. I want to get this. Can we get this on the S. And T. 183 00:24:22.440 --> 00:24:25.940 Porsche Dorsey: Can we do it? Let me see. I have a lot of notes here 184 00:24:29.030 --> 00:24:32.179 Porsche Dorsey: specifically the the plan, the rollout, 185 00:24:32.820 --> 00:24:35.229 Porsche Dorsey: twenty-seven twenty-eight rollout, 186 00:24:53.640 --> 00:24:59.879 Porsche Dorsey: and specifically for the smt I have other notes for other folks 187 00:25:01.080 --> 00:25:03.330 Porsche Dorsey: time between approval 188 00:25:03.690 --> 00:25:06.050 Porsche Dorsey: and iqrs updates 189 00:25:13.300 --> 00:25:16.060 Porsche Dorsey: and plan for testing, 190 00:25:31.860 --> 00:25:36.170 Porsche Dorsey: and then um, i'd like to also get with the Eltc folks, 191 00:25:36.390 --> 00:25:39.300 Porsche Dorsey: so something we can do offline um 192 00:25:39.530 --> 00:25:41.800 Porsche Dorsey: about inserting 193 00:25:44.890 --> 00:25:46.769 Porsche Dorsey: some kind of 194 00:25:47.280 --> 00:25:51.559 Porsche Dorsey: twenty-seven twenty-eight heads up um 195 00:25:51.960 --> 00:25:54.740 Porsche Dorsey: prior to the form approval. 196 00:25:54.820 --> 00:25:58.409 Porsche Dorsey: Um! And again i'll have to that'll have to go through 197 00:25:58.490 --> 00:26:03.619 Porsche Dorsey: program, and you know all the checks and balances to make sure 198 00:26:03.850 --> 00:26:07.520 Porsche Dorsey: we can give you something, but not too much. 199 00:26:13.600 --> 00:26:28.310 Nathan Muzos: Yeah, that would be awesome. And I just want to say, I appreciate you guys being willing to have the conversation and and being open to to these things? Ah, and push. I agree. I think it's some of this is going to generate questions 200 00:26:29.020 --> 00:26:38.109 Nathan Muzos: for all of us. Ah, but I think it's going to help us to have answers to those questions in advance of the transition, 201 00:26:38.500 --> 00:26:46.489 Nathan Muzos: whether that's people asking eot or engaging with us or their networks, we can compile those, bring them back to this group. 202 00:26:46.570 --> 00:26:54.519 Nathan Muzos: Um, so that they can be built into Faqs trainings all those things, and just makes that transition smoother. 203 00:26:54.680 --> 00:26:56.080 Nathan Muzos: So thank you guys, 204 00:27:01.220 --> 00:27:20.550 Michael Kennedy: it's Michael. I have one question that's not necessarily for the plan. But something you said made me think of um a different question I had for you, since it's still in Pra. And it's not. Finally a great do you anticipate changes from what we've known about? Because if there are 205 00:27:20.560 --> 00:27:27.460 Michael Kennedy: changes to it that will require code changes on the ado side as well for what we've been building in the system. 206 00:27:27.700 --> 00:27:35.589 Porsche Dorsey: So yes, there are a few changes mainly like demographically on sex gender things. 207 00:27:35.600 --> 00:27:36.760 Michael Kennedy: Okay, 208 00:27:36.770 --> 00:27:43.490 Michael Kennedy: Yeah. Um. When you know of those up, the quicker we can get some to quicker we can react to them. 209 00:27:43.500 --> 00:27:50.789 Porsche Dorsey: Yeah, yeah, no, understood. The The pickle is that we can get them to you. But what if they're slashed out, 210 00:27:50.870 --> 00:27:53.400 Michael Kennedy: you know, agreed Um. 211 00:27:54.400 --> 00:28:07.189 Michael Kennedy: My only anxiety is okay. We get a little free all day, and it's a P. To come into effect, but then we still have to build to it. Prepare it, update data dictionaries, work with Edsm, get it to the Edis and make sure that they can 212 00:28:07.200 --> 00:28:14.489 Michael Kennedy: still submit. Patients admits discharges, because those all fill out the form for the 213 00:28:14.640 --> 00:28:25.949 Michael Kennedy: Yeah. Um, i'm with you. It's it is a pickle. But um, whenever you do know, or if you can't tell us, because it may change, that is an answer as well, 214 00:28:26.390 --> 00:28:27.890 Porsche Dorsey: that is the answer. 215 00:28:28.790 --> 00:28:31.489 Porsche Dorsey: That is the answer. Unfortunately, 216 00:28:33.860 --> 00:28:43.600 Porsche Dorsey: anyone from my team program to speak up if i'm the speaking. But yes, that is the answer. As far as I know it. 217 00:28:53.270 --> 00:28:54.490 Porsche Dorsey: Okay, 218 00:28:57.930 --> 00:29:03.440 Porsche Dorsey: all right. That was a well-needed discussion. I'm glad we stopped there, 219 00:29:03.820 --> 00:29:04.970 Porsche Dorsey: and it's 220 00:29:09.700 --> 00:29:23.140 Geraldine Bojarski: this is Geraldine um I do have one question from dci um these just for an example, these new gender fields and all that, because it's twenty, seven, twenty, eight goes to the Security Administration. Are they also updating their 221 00:29:23.270 --> 00:29:28.490 Geraldine Bojarski: um software in order to accommodate these this information. 222 00:29:32.410 --> 00:29:35.789 Porsche Dorsey: So i'm not, too, into the weeds on on that end. 223 00:29:35.800 --> 00:29:51.239 Geraldine Bojarski: Well, the the reason why I ask is because right Now, you know we're not able to um modify. You know Mbi numbers or anything like that, because the uploads from the Security Administration and I just want to make sure that there's not going to be any um 224 00:29:51.490 --> 00:30:01.880 Geraldine Bojarski: in time. From the information from the Security Administration to Eqrs, because all the fields don't match, I guess, is my question. 225 00:30:10.070 --> 00:30:15.150 Porsche Dorsey: Yeah, that's something i'd have to dig around and see. I don't think any of us would know that 226 00:30:19.370 --> 00:30:27.430 Nathan Muzos: it's Nathan again. I'll P. You back off? Geraldine's question. Just a broader one Is the Social Security Administration aware? This is being updated, 227 00:30:27.510 --> 00:30:30.029 Nathan Muzos: and they're all of their offices. 228 00:30:32.180 --> 00:30:34.989 Nathan Muzos: We run into a number of struggles 229 00:30:35.530 --> 00:30:37.400 Nathan Muzos: with the local offices. 230 00:30:37.570 --> 00:30:43.150 Nathan Muzos: I can foresee someone saying this isn't the two thousand seven hundred and twenty, eight. I don't know what this is, 231 00:30:43.170 --> 00:30:44.769 Nathan Muzos: I need a real one 232 00:30:44.860 --> 00:30:47.780 Nathan Muzos: because they don't know the form has been updated. 233 00:30:48.220 --> 00:30:49.670 Nathan Muzos: Ah, you know, 234 00:30:49.850 --> 00:30:53.099 Nathan Muzos: month ago, whenever this actually happens. 235 00:30:54.820 --> 00:31:09.839 Porsche Dorsey: Yeah. So i'm actually not responsible or not in on the pra processes, and how all of that is handled when these, when these um forms are updated and these official forms are updated. Um, that the O. And the office and 236 00:31:09.850 --> 00:31:23.620 Porsche Dorsey: folks handle that above my head. But um, I I mean I would be confident that all parties who would be impacted on a form would be included on the form um on any updates that are occurring. 237 00:31:24.800 --> 00:31:26.560 Porsche Dorsey: But I don't um. 238 00:31:27.500 --> 00:31:33.800 Porsche Dorsey: Personally, I do not know that. Does anyone else in program? Would you like to add to that response? 239 00:31:37.900 --> 00:31:47.830 Michael Kennedy: Not program. But I have some insight if you wanted. Sure. Okay, Geraldine, the two thousand seven hundred and twenty eight, Is it a one-to-one to the Ssa system? 240 00:31:48.680 --> 00:31:54.300 Michael Kennedy: The current version which we just heard is subject to change, and may have it slashed, 241 00:31:54.620 --> 00:32:08.510 Michael Kennedy: included Asex at birth, which would be mapped. And then also, that is what is used. If we were using patient matching directly to their system. They are not updating their system. The two thousand seven hundred and twenty-eight, and the additional information collected was also 242 00:32:09.620 --> 00:32:26.629 Michael Kennedy: partly for data collection in different studies in the twenty, seven, twenty, eight worker, and in the previously approved version. Um, for instance, like Jelly and Nathan, et cetera, just like we've done in the past, in two thousand and six, with different fields collected. That was the last big change team. 243 00:32:27.590 --> 00:32:42.350 Michael Kennedy: Nih was on that work group. Social security was on that work rate different doctors, different entities. Um, Nathan, you were on network right where some of the people were asking for various things. Um, that is where some of it came from and 244 00:32:42.360 --> 00:32:51.220 Michael Kennedy: does. Some of the new appeal may not be a one to one directly to social security. And Cdc. Wanted some things in there, 245 00:32:51.920 --> 00:33:20.860 Michael Kennedy: Ah, transplant and education and other things that they were doing so the entirety of the form isn't necessarily a one-to-one, and our patient matching algorithm in the back end of the Qrs and the the markers and bills that we use for that wouldn't be impacted. Um, once we get a patient match charity that's in certain fields that come on down, that is, after it gets connected through from it. In the Apis to social security we get it, and we know that that is their Nbi. This is the patient. We have the 246 00:33:20.870 --> 00:33:27.170 Michael Kennedy: call a patient Id from the Ssa system. That's when all of that gets locked down so that it can ever be corrupted. 247 00:33:29.930 --> 00:33:41.340 Geraldine Bojarski: Okay, I I just want to. I just want to make sure that we don't have a lot of patience um without the the Mbi downloads, 248 00:33:41.350 --> 00:33:56.380 Geraldine Bojarski: and then the clinic will go ahead and complete twenty-seven twenty-eight and submit it anyway. Um! Only because the social Security Administration can't make a definitive map based off of, you know. Name date of birth, gender, you know. Possible security and that kind of stuff. 249 00:33:56.580 --> 00:34:10.090 Michael Kennedy: We would not use the current gender identity to match that because it could change, or whatever. But that sex at birth is what we would maintain as we could match to their system. 250 00:34:18.159 --> 00:34:22.509 Michael Kennedy: What we know today See, Portia, I can learn. I can qualify. 251 00:34:22.630 --> 00:34:26.299 Michael Kennedy: Thank you so much, Michael. 252 00:34:28.520 --> 00:34:31.769 Porsche Dorsey: All right. Where are we in this agenda. 253 00:34:39.989 --> 00:34:50.389 Porsche Dorsey: Does this kind of speak to seventeen? Um. May then the conversation what Michael just explained. How will the new data field be incorporated into the patient demographics. 254 00:34:52.810 --> 00:34:55.729 Nathan Muzos: No, I mean it's not really 255 00:34:55.820 --> 00:34:57.900 Nathan Muzos: so. Security related. So 256 00:34:58.170 --> 00:34:59.340 Nathan Muzos: that's it. 257 00:34:59.790 --> 00:35:11.040 Nathan Muzos: Like Michael mentioned the patient demographic, Our patient demographic submissions feed the patient demographics section of the Qrs, which feeds 258 00:35:11.070 --> 00:35:12.740 Nathan Muzos: the twice are twenty-eight. 259 00:35:12.880 --> 00:35:24.030 Nathan Muzos: And so if you guys are adding new fields to that section of the form, what we're asking is, How will that be collected in the patient demographics file? 260 00:35:24.130 --> 00:35:31.969 Nathan Muzos: Mainly will they be required? So we we had this discussion a couple years ago around race and ethnicity. 261 00:35:32.080 --> 00:35:49.319 Nathan Muzos: Um, And it was determined, Cms. Determined that in order to submit, a patient demographic record, race and ethnicity would be required to be in that submission. What that means is, if we don't have an answer to one of those fields in our system, 262 00:35:49.330 --> 00:35:53.419 Nathan Muzos: we either Don't send it, or, if we send it, A. Qs. Rejects it. 263 00:35:53.980 --> 00:36:03.900 Nathan Muzos: And so if you for it, if Cms, for instance, decides that gender identity is going to be a required field in patient demographics, 264 00:36:04.250 --> 00:36:07.499 Nathan Muzos: we don't have the ability to send an unknown. 265 00:36:07.900 --> 00:36:09.100 Nathan Muzos: Ah, 266 00:36:09.810 --> 00:36:14.709 Nathan Muzos: we don't collect that today. We will not be able to send any. 267 00:36:14.820 --> 00:36:20.080 Nathan Muzos: Our patient admissions and discharge information in the Ecos electronically. 268 00:36:20.530 --> 00:36:23.909 Nathan Muzos: That will be a dramatic shift from where we are today. 269 00:36:25.800 --> 00:36:33.120 Nathan Muzos: So what we have asked is any of these new fields be optional in-patient demographic submissions, 270 00:36:33.230 --> 00:36:36.850 Nathan Muzos: because the thinking me how bad is it 271 00:36:37.240 --> 00:36:41.979 Nathan Muzos: that isn't needed to send in admission and discharge information? 272 00:36:42.230 --> 00:36:49.590 Nathan Muzos: We are okay, at least I guess For this i'll speak for myself. I am okay. If they were required on the two thousand seven hundred and twenty eight 273 00:36:49.880 --> 00:36:53.050 Nathan Muzos: that you can't submit that form without that data. 274 00:36:53.380 --> 00:37:00.720 Nathan Muzos: But for patient demographics, admission, discharge treatment, information. It should be optional because it 275 00:37:00.880 --> 00:37:05.709 Nathan Muzos: the answer to gender identity doesn't impact their admission 276 00:37:05.830 --> 00:37:08.979 Nathan Muzos: or their discharge date or it shouldn't. 277 00:37:10.320 --> 00:37:17.909 Nathan Muzos: And so that's where um The answer to this question, you know, if you guys come back and say, yes, they will all be made optional. 278 00:37:18.340 --> 00:37:27.200 Nathan Muzos: That's awesome, and the conversation will essentially stop there, and we'll move forward. But if they come back as these will be required, 279 00:37:27.270 --> 00:37:36.369 Nathan Muzos: then It needs much more of a conversation, much more of a plan and a strategy to roll this out, because all Edis will be impacted 280 00:37:36.600 --> 00:37:40.800 Nathan Muzos: dramatically. If patient demographics goes that direction. 281 00:37:48.850 --> 00:37:52.240 Nathan Muzos: Does that help add some context? Hopefully, 282 00:37:54.560 --> 00:37:56.029 Porsche Dorsey: it does 283 00:38:07.340 --> 00:38:13.960 Porsche Dorsey: second of seem to scope the utility of the patient demographic about an hour, and 284 00:38:17.040 --> 00:38:26.140 Porsche Dorsey: Is that A. Is that a conversation for you, Michael? That the utility of the patient demographic file for us? 285 00:38:28.890 --> 00:38:37.190 Michael Kennedy: I'm the sneak, so I can definitely be involved. I'm. Not necessarily the team on the team that does the coding, but you 286 00:38:37.470 --> 00:38:47.170 Michael Kennedy: the bluff of it is portion. The quicker we have a final version. The quicker we can complete the data dictionary and the rules 287 00:38:47.180 --> 00:38:57.760 Michael Kennedy: that Gms. Has mandated and give it to the Edi so that they can complete their system updates to be able to submit it and know what's coming. 288 00:38:58.110 --> 00:39:13.589 Michael Kennedy: If one day we just turn it on and say, you can no longer submit patients without specific fields that would break it if we do it in an organized fashion and roll it out. Get them the information ahead of time, and give them a runway to react to it 289 00:39:13.600 --> 00:39:20.429 Michael Kennedy: before we turn it on in our system that drastically changes the conversation. I do think 290 00:39:20.580 --> 00:39:29.490 Michael Kennedy: optional for patient demographics is one thing versus the form. The form was intended to collect the data for studies and other things that come down from it. So 291 00:39:29.570 --> 00:39:33.059 Michael Kennedy: I don't have heart burning or anything like that at all. Um. 292 00:39:33.220 --> 00:39:36.440 Michael Kennedy: But making sure that we can get 293 00:39:37.220 --> 00:39:50.610 Michael Kennedy: the right fields and the final fields, and what type of field it is, what the expected values are, What the validations. Is it an error or a warning? All of that stuff they will need as quickly as possible? 294 00:39:50.870 --> 00:40:01.760 Michael Kennedy: Um! From when we know the form will be final, even if it's before it's publicly released. If we know that this is the final version of changes, we can start working to make the systems 295 00:40:01.930 --> 00:40:09.449 Michael Kennedy: for that, so that it doesn't take months and months of other rework and or failures, or 296 00:40:09.960 --> 00:40:14.460 Michael Kennedy: I mean Nathan. I'll use you as an example, because we knew each other one another. 297 00:40:14.470 --> 00:40:31.050 Michael Kennedy: If I just turn it on September first, and that's the first thing he gets it, and it's expected to be in production that day. He has no clue what should be there, and his entire company system, and all of his facilities will have to be retrained, and that won't happen 298 00:40:33.350 --> 00:40:36.149 Michael Kennedy: unless you have some new magic that i'm not aware of. 299 00:40:36.270 --> 00:40:40.220 Nathan Muzos: No, that that will take three to four months, probably minimum 300 00:40:44.420 --> 00:40:45.660 Nathan Muzos: urge you, 301 00:40:45.670 --> 00:40:50.209 Nathan Muzos: and that that is with the assumption that it's a data point we collect today. 302 00:40:50.420 --> 00:40:53.579 Nathan Muzos: It's a data point we Don't collect today. 303 00:40:53.620 --> 00:40:55.349 Nathan Muzos: I would give it a year 304 00:40:55.660 --> 00:40:57.569 Nathan Muzos: before we start collecting it 305 00:40:58.520 --> 00:41:05.930 Nathan Muzos: because of the lead times, our internal systems funding prioritization, all of those things in our internal systems. 306 00:41:08.490 --> 00:41:11.120 Nathan Muzos: So that's the sort of lead times 307 00:41:11.650 --> 00:41:13.390 we are talking about. 308 00:41:16.240 --> 00:41:18.419 Porsche Dorsey: Okay, 309 00:41:18.430 --> 00:41:32.490 Porsche Dorsey: Um, if it helps. There is precedent for this, and because actually race and ethnicity and even current um employment size are optional in the patient demographic file, 310 00:41:32.500 --> 00:41:42.850 Kathleen Prewitt: and then, when you go to do the twenty-seven twenty-eight, it'll throw up an area that says Well, you actually need to go. Enter this to be the two thousand seven hundred and twenty-eight. So there's precedent to make these new fields optional. 311 00:41:49.860 --> 00:41:51.819 Porsche Dorsey: Thanks, Kathleen. That's helpful. 312 00:41:57.450 --> 00:42:12.369 Porsche Dorsey: Okay, all right, I have. I have notes on this. I'll discuss with the team. It sounds like um. The biggest thing right now is to start getting some preemptive communications as much as we're able to. I have a rollout plan 313 00:42:12.380 --> 00:42:31.750 Porsche Dorsey: on our agenda for us to begin to start. Really looking at that we definitely want to do things obviously and decency and in order. So we're not going to have any unrealistic expectations. That's our goal not to have unrealistic expectations between, you know. Go, live, and and 314 00:42:31.760 --> 00:42:37.650 Porsche Dorsey: and knowing that your systems need to, you need to get your systems up to speed. So 315 00:42:37.670 --> 00:42:38.759 Porsche Dorsey: um 316 00:42:39.690 --> 00:42:46.919 Porsche Dorsey: i'm happy to continue that conversation, but I hope to have more of an update on that front the next time we need. 317 00:43:06.540 --> 00:43:08.069 Porsche Dorsey: Okay, 318 00:43:18.530 --> 00:43:19.819 they've made some pressure 319 00:43:19.840 --> 00:43:21.019 for the trousers. 320 00:43:21.190 --> 00:43:24.619 Porsche Dorsey: Looks like Graham boy jumping down to twenty. 321 00:43:42.660 --> 00:43:44.320 Porsche Dorsey: So i'm having parts of reading it. 322 00:44:23.330 --> 00:44:28.170 Porsche Dorsey: Okay, I do not have uh responses to twenty at the moment. 323 00:44:29.210 --> 00:44:38.109 Kelsey Okland: Okay, yeah, this is calcium with Usrc. We just wanted to make sure if it does go into final role that it's on the radar, for in the future 324 00:44:42.370 --> 00:44:45.689 Porsche Dorsey: Got it? Got it, and I get there. That makes sense. 325 00:44:48.460 --> 00:44:49.790 Kelsey Okland: Great. Thank you. 326 00:44:49.800 --> 00:44:50.609 Porsche Dorsey: Yeah, 327 00:44:50.800 --> 00:44:54.140 Porsche Dorsey: Yeah, we'll just leave this one here. Melissa and i'm sure it'll 328 00:44:54.420 --> 00:44:57.090 Porsche Dorsey: It'll come back and back up, 329 00:45:03.070 --> 00:45:05.099 Nathan Muzos: can we? Uh 330 00:45:05.970 --> 00:45:08.470 Nathan Muzos: can we jump back up to Number Ten? 331 00:45:08.680 --> 00:45:11.080 Nathan Muzos: I think we skipped over that one 332 00:45:11.170 --> 00:45:13.609 Nathan Muzos: because that's less uh like 333 00:45:14.150 --> 00:45:15.859 Nathan Muzos: peritinitis? 334 00:45:16.000 --> 00:45:17.339 Nathan Muzos: Ah! 335 00:45:18.500 --> 00:45:23.390 Nathan Muzos: Like infection! How does it relate? What do we report questions? And it's more of a system 336 00:45:23.590 --> 00:45:34.760 Nathan Muzos: limitation that we see both in peritonitis and vaccinations. So i'm just wondering if there's any update on that, and then the the update from July says there will be a short-term workaround 337 00:45:34.910 --> 00:45:35.979 Nathan Muzos: Ah, 338 00:45:36.320 --> 00:45:38.580 Nathan Muzos: I might have missed if that was provided. 339 00:45:44.520 --> 00:45:49.219 Porsche Dorsey: I don't think we have Adrian, who can speak to this one, 340 00:45:51.400 --> 00:45:53.620 Porsche Dorsey: and we don't, have you, that 341 00:45:56.580 --> 00:46:00.080 Porsche Dorsey: we may not have the folks on that can speak to this. 342 00:46:00.770 --> 00:46:02.490 Porsche Dorsey: That's um 343 00:46:03.730 --> 00:46:13.289 Michael Kennedy: speak to. Why, it was built that way. But I can say i'll take it back to those teams on our Pdmpo call 344 00:46:15.570 --> 00:46:16.929 Nathan Muzos: great. Thank you, 345 00:46:18.720 --> 00:46:21.680 Melissa Fieldhouse: Michael. What was that that call you mentioned? 346 00:46:21.960 --> 00:46:37.739 Michael Kennedy: Um. We have a weekly call between the product owners and the Cms. Pdms: The product managers. Um to discuss request system updates make tickets for Pi planning, et cetera, for prioritization. So i'll add it to that agenda. 347 00:46:37.780 --> 00:46:39.229 Melissa Fieldhouse: Thanks. 348 00:46:46.820 --> 00:46:48.979 Nathan Muzos: Yeah, I appreciate that. I just didn't want 349 00:46:49.170 --> 00:46:53.969 Nathan Muzos: that one, I I think, is under peritonitis, but it's very different than 350 00:46:54.350 --> 00:46:57.170 Nathan Muzos: the paradigm is actual questions that we have. 351 00:46:57.770 --> 00:47:00.419 Nathan Muzos: It's just where it was raised. 352 00:47:00.740 --> 00:47:02.750 Nathan Muzos: She didn't want it to get lost in there. 353 00:47:02.760 --> 00:47:05.619 Nathan Muzos: It's a date functionality. Yeah, I'll see. Yeah, 354 00:47:05.640 --> 00:47:07.009 Michael Kennedy: i'll see what they think 355 00:47:07.240 --> 00:47:08.869 Nathan Muzos: awesome. Thank you. 356 00:47:17.680 --> 00:47:21.579 Porsche Dorsey: Okay. Well, anything else. What? We kind of wrap up here 357 00:47:24.380 --> 00:47:25.649 Porsche Dorsey: call 358 00:47:32.460 --> 00:47:43.910 Porsche Dorsey: all right. It looks like we get folks about ten minutes back. Thank you so much for your lively discussions today, and we will see you all in two weeks. 359 00:47:46.750 --> 00:47:50.930 Nathan Muzos: All right. Take care, everyone. Thank you for watching. Thanks, Porsche. Thanks.